Free Fee app - short form - committee work (219154.DOC;1) - Minnesota

UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA In re: __________________, BKY ____________

Debtor. ______________________________________________________________________________ APPLICATION FOR COMPENSATION AND REIMBURSEMENT OF EXPENSES BY ATTORNEY FOR DEBTOR(S) IN CHAPTER 13 CASE ______________________________________________________________________________ The undersigned applicant, pursuant to Local Rule 2016-1(d), states that: 1. 2. The Applicant is the attorney for the Debtor(s). The status of the case is as follows: [ ] A plan has been confirmed; [ ] No plan has been confirmed and the case is pending; or [ ] No plan has been confirmed and the case has been dismissed. The trustee has funds on hand in the amount of $ 3. .

Applicant seeks allowance of fees and reimbursement of expenses as follows: Fees: Expenses: Filing Fee Copies Postage Other (Itemize) Total Expenses Total Fees and Expenses: $ __ (#) @ $.__ = (#) @ $__.__ = $ $ $ $ $ $

(collectively, "Requested Fees and Expenses.") If the requested expenses include costs in addition to the expenses listed above, an itemization is attached to this application.

4.

The Requested Fees and Expenses constitute reasonable compensation for actual, necessary services rendered by the Applicant and actual, necessary expenses incurred on behalf of the Debtor(s). The services provided consist of the following: [ ] Pre-confirmation services; or [ ]Post confirmation services consisting of the following: [ [ [ [ [ [ ] ] ] ] ] ] Resolving motion(s) for relief from stay Resolving motion(s) for dismissal Filing motion(s) for sale of real estate Filing motion(s) objecting to claim(s) Preparing, serving and filing modified plan(s) Assisting the debtor in complying with § 521(f)(4) Assisting the debtor in responding to requests for information made in connection with an audit conducted pursuant to 28 U.S.C. Section 586(f)

[ ]

5.

Regarding the Requested Fees and Expenses, the Debtor(s) has paid Applicant thesum of sum of $______________ as of _____________ [insert date]. The Debtor(s) owes the Applicant the sum of $__________ for the unpaid balance. The Applicant has applied for fees and/or expenses in this case as follows:
Amount of Application Date of Order Amount Allowed Paid to Date

6.

Date of Application

7.

The applicant has not shared or agreed to share with any other person, other than with members of this applicant's law firm, any compensation paid or to be paid in this case. WHEREFORE, the applicant requests the Court to enter an Order as follows: (A)Awarding $, the unpaid balance stated in paragraph 5 above, for compensation and/or reimbursement; and (B)If no plan is confirmed, authorizing the Chapter 13 trustee to disburse to Applicant from funds on hand, funds in the amount of the fees and expenses allowed hereunder.

Dated: _______________

/e/ Atty Name: Address:
Telephone, Attorney(s) for Debtor(s):

UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA In re: __________________, BKY ____________

Debtor. ______________________________________________________________________________ ORDER ______________________________________________________________________________ This case came before the Court on the Application for Compensation and Reimbursement of Expenses by Attorney for Debtor(s) in Chapter 13 Case. Appearances, if any, were noted on the record. Based on the application and the file, record and proceedings herein, IT IS ORDERED: 1. Applicant is awarded $ , the unpaid balance stated in paragraph 5 of the application, for compensation and/or reimbursement. 2. If no plan is confirm the Chapter 13 trust e is authorized to disburse to Applicant ed, e from funds on hand, funds in the amount of the fees and expenses allowed hereunder. BY THE COURT:

Dated: _________________

_____________________________ U.S. Bankruptcy Judge